Emergency Rooms for 1000, Alex.

A story that will make you long to hide in a supply closet decorated with whales and fish.

A vandalized statue of Hippocrates near my local emergency room

My favorite part of the show Jeopardy! is toward the beginning, when the host chats with the contestants about themselves. Each of the three people is introduced by their name, location, profession, and then asked to talk about a specific aspect of their life, something funny or unique or odd that the contestant clearly wrote down for the host prior to the taping of the show. Given that these people assumedly have a long time to decide what one thing they should share about themselves on TV, I’m always entertained by the blandness of the biographical facts they choose. The more interesting contestants enjoy knitting scarves in their spare time, or are writing fantasy novels. There is also, inevitably, one stamp or coin collector in each batch. They must have a collector-contestant quota that needs to be filled.

If I’m ever on Jeopardy!, I know exactly what my fun biographical fact will be.

“Welcome Natalie, a mostly-jobless person from San Francisco!” Alex Trebek will say, tapping his cue cards on my podium. (My imagination is very outdated, as we’re already two hosts removed from the Trebek era.) “You and I were chatting earlier about your skills in emergency room navigation. Tell me more.”

“That’s right Alex,” I will say, “I’ve been to the ER so many times, I can get around it blindfolded!”

“That’s impressive! The next time I’m having a medical emergency in San Francisco and I need to find the bathroom, I know who I’ll call!”

“Just be sure to call me from the waiting room, Alex, as most of the ER I go to is actually a cell phone dead zone.”

“Wow! You really are an expert,” Alex will say. Then we’ll share a good-natured laugh.

During certain phases of my struggle with chronic migraine disorder, I’ve frequently visited the ER with nasty, days-long migraines. By now, I’ve seen every corner of the place, and I mean every corner: During one of my longer visits, when no private rooms were available, a nurse rolled my bed into a supply closet so I could try and get some sleep. I didn’t fall asleep in the closet, because I was in a lot of pain, but I do remember enjoying the decor. The supply closet had been some sort of pediatric exam room before getting repurposed, its walls painted in baby blue with whimsical whales and fish. But usually, my bed would be in one of the ER’s many hallways, exposed to both the harsh fluorescent lighting and the sounds of blaring, beeping medical equipment.

My most recent visit to the ER was in the fall of 2022. This was well past the height of the pandemic, when coming to the ER for something as “inconsequential” as a migraine would have been out of the question. Luckily, I’d had a lot more at-home options that worked for me during the unprecedented times. Something that was in full swing then, however, was the California nursing shortage. Given how many Bay Area techies had been relieved of their jobs at around this same time, I think we should have sent the software engineers out to the hospitals to fill the empty nursing ranks. It would have been a good way to instill people skills in an under-socialized sector of the workforce. But no one asks for my opinion on these things. 

Accounting for the nursing shortage, I thought I knew what to expect as I prepared to go to the ER. I figured it would be like it always had been, except with fantastically inflated wait times, so I took one of my precious opioid painkillers before leaving home. Opioids are nearly verboten in both headache medicine and at federally-funded academic medical facilities, like the one I go to. Soon, they’ll be demanding I provide three different character references with each refill request. But if it could take hours for me to get treated, I saw no reason to be in blinding pain while I waited. I also packed my pillow, eye mask, phone charger, and white noise earbuds. I hadn’t brought food or drinks, because I knew I could always ask my nurse for apple juice, graham crackers, etc.

 A complication that may be worth mentioning: This time that I went to the ER, it was because I had COVID. I was breathing fine and generally feeling ok, except for the five-alarm fire that had been burning in my head for three days. I’d had my fair share of bad headaches by that point, as my chronic migraine disorder began before the pandemic, but my COVID migraines were a force to be reckoned with. I’d barely slept since getting infected, so decided it was time to try my luck at getting some IV medications. The usual drugs they give for migraines in the ER take about an hour to run, so I figured the whole process would take four, maybe five hours from beginning to end. Five hours of misery would be worth it if it meant I’d finally feel well enough to sleep. But this would be my first solo trip to the ER. Because I had COVID, visitors were not allowed.

My bed ended up being in the hallway, again. But this time, I was siphoned off by doors on either end, just past the staff and paramedic entrance on the ground floor. I’d never seen beds in this hallway before, and it was easy to tell why: Every few minutes, the tall glass panels of the paramedic doors swung inward, gave a loud thunk, and admitted both a large whoosh of cold air and a soul (un)fortunate enough to bypass the waiting room. It was a far cry from the oceanic supply closet, and as I shivered beneath my flannel shirt, I wished I’d brought a heavier coat.

I arrived at three in the morning, as the other COVID patients in the makeshift ward were on their way out. Take two Tylenol for the headache, I heard a doctor say to each of them in turn. I couldn’t see the doctor, because I had arranged my eye mask—which was bright blue with bulb-out cups, like a little fashion bra—above my face mask. I listened to the thunk, whoosh of the doors as I waited to hear footsteps of the doctor approaching my bed from behind. The elastics from both the eye bra and the face mask gripped my head too tightly, pushing my hair up into a big, frizzy bubble. No nurse had come yet to start an IV.

The doctor—a resident, according to his badge—eventually came to see me. The top half of his face looked cool, confident, and a little like John Krasinski. This is not who I expected for August, the month after they release first-year residents on emergency room rounds. He didn’t recommend the Tylenol route, probably because he saw my mile-long medical record on his computer screen, and he seemed amenable to the list of meds I rattled off from memory. But when he left, no nurse came.

Eventually, I was the only one left in the hallway—my hallway—and I had to pee. I knew the way to the nearest bathroom, which was just past the doors at the far end of the hall. So I got out of the bed, put on my shoes, and went on my way. I made it at most ten steps before hearing the no-nonsense voice of a middle-aged woman yell from behind me. 

“Where are you going?!” she said. She was a tech with an EKG machine, who had snuck into my hallway through some doors halfway down. 

“Uh, the bathroom?” I replied.

“You have COVID, you can’t use the regular bathroom! You have to stay here and use a commode.” 

There is rarely any point to arguing with a person in scrubs, but there’s even less of one when nobody else is within earshot. So she brought me a commode, which is the hospital equivalent of a camping toilet, and I sat down to do my business. While my pants were still around my ankles, I heard a thunk, whoosh. It was another wave of paramedics, rolling their charges straight through my powder room. As soon as I’d finished, the tech slid my shirt up to my neck, then attached the EKG leads to my stomach and chest. As she did, a bearded man with wild eyes ran into my hallway, then out through the double doors. He was wearing a hospital gown and no shoes.

“Hey! Hey! A patient just got out!” the tech yelled over her shoulder. 

“Ugh,” someone half-yelled, half-groaned from beyond the doors at the far end, “just forget about it!”

“Wow, this place is nuts. Also, these doors are pretty annoying,” she said with a sigh as another thunk, whoosh brushed goosebumps all over my exposed skin.

Me in my hallway and face bra. I must have tidied my hair before taking this photo.

At five-thirty, it was still dark outside, and I was alone again in my hallway. The opioid I’d taken before leaving home would begin wearing off at six, maybe seven am. The EKG tech had left “to find my nurse” an hour earlier, and the only people I’d heard since were paramedics coming through the double doors. 

I was also parched, so I was relieved when a man in scrubs arrived through the side doorway. He was a tech, there to get an EKG. 

“But I’ve already had an EKG,” I said, pulling up my shirt to show him the sticky electrodes. They were beginning to fuse with my skin. I wondered if a screwdriver would be sufficient for prying them off after I got home, or would I need to rip patches of my stomach off in big chunks? The tech looked disappointed, and a little confused, that I’d already had an EKG. So I asked him, gently, for a cup of water.

“Your nurse can bring you water,” he said.

“And who is my nurse?” I asked.

“I’ll go check.”

A few minutes later, he returned himself with a cup of water. After polishing off the plain paper cup, I put my eye bra back on with some hesitation—the ceiling lights were punishing, but I didn’t want to miss a nurse sneaking in under cover of the thunk, whooshes that beat like a drum against the plastic-lined walls.

At around six-thirty, a familiar gnawing ache began to work its way across my face. This, I knew, was only the beginning. A third tech also came, to get an EKG. Forget about nurse shortage, I was beginning to wonder if there had been a nurse mass extinction event, like with the dinosaurs. Though it was good to know that the EKG tech population was alive and well. 

And then, finally, they came. I heard a thunk and a whoosh, then another, and another. Thunk, whoosh. Thunk, whoosh. Thunk, whoosh. I peeked out from under my eye mask to see people with RN badges hung on lanyards around their necks, gliding through the double doors and into the ER, the wind blowing their hair and dusting their cheeks with red, like they were all starring in a hospital-themed shampoo commercial. I was gobsmacked by the arrival of my only hopes for feeling better. I even considered asking them to sign autographs or take selfies with me. But none of the nurses looked my way, and I didn’t expect them to. At seven was when the shift changed, so that’s when they would begin cleaning up vomit, drawing blood, swabbing noses, and doing all sorts of other undesirable tasks for twelve straight hours. But it wasn’t seven yet. For the time being, I took comfort in my celebrity sightings, proof that nurses still existed. The nurses’ station was just on the other side of the wall, and the roars of laughter and waves of chatter grew louder as the sun came up. It sounded like a fun party, but I hadn’t been invited.

For two and half more hours it was just me, the thunk, whooshes, and an increasing amount of chilly San Francisco fog growing into a cloud around my bed. Before long, my hallway would be developing its own weather patterns. I was getting hungry and very, very migrainey. I felt like a cartoon after a close encounter with an anvil, their head swollen and encircled by birds or stars. I’d been in my hallway for six hours—most of a workday—without getting any treatment for my migraine or even talking to a single nurse. I was far past the point of regretting I’d come, but this sort of remorse is rarely productive. It’s not like I had a choice, not if I wanted to feel better anytime soon. I was also too tired to feel much of anything for very long—anything other than pain, that is. I did, however, kick myself for not bringing food and a water bottle. It was a rookie mistake, and I’d suffered for it.

The next person to come into my hallway was a tech, to get an EKG. Just kidding. They came to roll my bed into a private room with a wide, sliding glass door. I recognized the room, which felt like a fish tank, as one I’d been in twice before. It was the worst of the private rooms, as it shared a wall with another, much more utilized, supply closet. I was starting to miss my hallway already, not because it was all that comfortable or quiet, but because it had served me faithfully as both a bathroom and a bedroom in a world that otherwise couldn’t be bothered to stick a needle in my arm. By the door to my new room, above the light switch, hung a flyer I’d never seen before. It had a QR code on it, and above the QR code were the words: Please fill out the emergency department patient satisfaction survey. My nurse was on her way, the tech said before turning to leave. 

“Excuse me, could you bring a commode?” I asked a nurse who was sitting across the hall from my room, spinning a pen between his fingers. I’d needed to pee for a while before popping my head out to ask. I figured I could wait to ask my own nurse, but they  hadn’t yet come, so now I was doing the potty dance.

“Um, it looks like you can walk, why don’t you walk to the bathroom?” the nurse replied.

“I can walk to the bathroom, but I have COVID, so I thought I wasn’t allowed to.”

“Who told you that?”

“An EKG tech.”

“Oh,” he said, flatly. “Whatever, just use the bathroom. It’s over there.”

Given my intimate knowledge of my surroundings, I wanted to say, “I know, and don’t you know you’re talking to Natalie Mead, ER Navigator, First Class?” Instead, I said, “Thank you.” As I walked toward the dirtiest of the ER’s bathrooms with my eye bra pushed up onto my forehead, I thought of the man who had escaped earlier that morning through the paramedic doors. I felt jealous of him, for multiple reasons. For one, he was now somewhere other than in this ER, where I was slowly wasting away. But this wasn’t my only gripe with the lucky escapee. I was also jealous because he, not me, was now in possession of the best Jeopardy! contestant biographical fact of all time, and he probably didn’t even care. 🧠

Many thanks to Kat Foley for editing this piece.